Provider Demographics
NPI:1174276471
Name:PALM BEACH BEHAVIORAL CENTER
Entity Type:Organization
Organization Name:PALM BEACH BEHAVIORAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARLENYS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ-CAMARGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-308-0818
Mailing Address - Street 1:3015 S CONGRESS AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2111
Mailing Address - Country:US
Mailing Address - Phone:561-308-0818
Mailing Address - Fax:561-444-3491
Practice Address - Street 1:3015 S CONGRESS AVE STE 2
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2111
Practice Address - Country:US
Practice Address - Phone:561-308-0818
Practice Address - Fax:561-444-3491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-27
Last Update Date:2023-05-11
Deactivation Date:2022-11-11
Deactivation Code:
Reactivation Date:2023-05-11
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty